Wortsman J, Dietrich J, Apesos J, Folse J R
Arch Surg. 1981 Apr;116(4):386-8. doi: 10.1001/archsurg.1981.01380160010002.
We reviewed a group of 30 patients with Hashimoto's thyroiditis who underwent thyroidectomies for suspicion of cancer. A prominent nodule was present in all of the patients; compression symptoms were present in 13 and pain in the thyroid in six. The nodule was cold on scan in 21 patients. Lack of responsiveness to suppressive therapy or nodule enlargement occurred in 18 patients. In addition to the nodule, operative findings included adherence to surrounding tissues in seven patients, lymphadenopathy in seven, increased vascularity in four, and extension to distant cervical structures in two. Pathologic findings in the nodule were similar to those in the rest of the gland; they consisted of lymphocytic infiltration, fibrosis, and variable follicular size. Examination of lymph nodes demonstrated lymphoid hyperplasia. We emphasize the similarities between chronic thyroiditis and carcinoma of the thyroid; the occasional coexistence of these two conditions stresses the need for newer methods in the differential diagnosis.
我们回顾了一组30例因怀疑癌症而接受甲状腺切除术的桥本甲状腺炎患者。所有患者均存在一个明显的结节；13例有压迫症状，6例甲状腺疼痛。21例患者的结节在扫描时呈冷结节。18例患者出现对抑制性治疗无反应或结节增大。除结节外，手术发现包括7例与周围组织粘连、7例淋巴结病、4例血管增多以及2例延伸至远处颈部结构。结节的病理发现与腺体其他部位相似；包括淋巴细胞浸润、纤维化和滤泡大小不一。淋巴结检查显示淋巴样增生。我们强调慢性甲状腺炎与甲状腺癌之间的相似性；这两种情况偶尔并存强调了在鉴别诊断中需要更新的方法。
